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Volume 113, Nº 5, November 2019


DOI: http://www.dx.doi.org/10.5935/abc.20190147


Prevalence of Masked and White-Coat Hypertension in Pre-Hypertensive and Stage 1 Hypertensive patients with the use of TeleMRPA

Weimar Kunz Sebba Barroso

Audes Diógenes Magalhães Feitosa

Eduardo Costa Duarte Barbosa

Roberto Dischinger Miranda

Andréa Araújo Brandão

Priscila Valverde Oliveira Vitorino

Lúcio Paulo de Souza Ribeiro

Marco Mota Gomes

Figure 3 – Participants classified as prehypertensive and stage-1 hypertensive patients considering the casual measurement and reclassified according to the HBPM, n = 1,273.


Background: The diagnosis of arterial hypertension based on measurements of blood pressure in the office has low accuracy.

Objective: To evaluate the prevalence of masked hypertension (MH) and white-coat hypertension through home blood pressure monitoring (HBPM) in pre-hypertensive and stage 1 hypertensive patients.

Method: Retrospective study, of which sample consisted of individuals with BP ≥ 120/80 mmHg and < 160/100 mmHg at the medical office without the use of antihypertensive medication and who underwent exams on the HBPM platform by telemedicine (TeleMRPA) between May 2017 and September 2018. The four-day MRPA protocol was used, with 24 measurements, using automated, validated, calibrated equipment with a memory function.

Results: The sample consisted of 1,273 participants, of which 739 (58.1%) were women. The mean age was 52.4 ± 14.9 years, mean body mass index (BMI) 28.4 ± 5.1 kg/m2. The casual BP was higher than the HBPM in 7.6 mmHg for systolic blood pressure (SBP) and 5.2 mmHg for diastolic blood pressure (DBP), both with statistical significance (p < 0.001). There were 558 (43.8%) normotensive individuals; 291 (22.9%) with sustained hypertension; 145 (11.4%) with MH and 279 (21.9%) with white-coat hypertension (WCH), with a diagnostic error by casual BP in the total sample in 424 (33.3%) patients. In stage 1 hypertensive individuals, the prevalence of WCH was 48.9%; in prehypertensive patients, the prevalence of MH was 20.6%.

Conclusion: MH and WCH have a high prevalence rate in the adult population; however, in prehypertensive or stage 1 hypertensive patients, the prevalence is higher. Out-of-office BP measurements in these subgroups should be performed whenever possible to prevent misdiagnosis. (Arq Bras Cardiol. 2019; 113(5):970-975)

Keywords: Hypertension/diagnosis; Masked Hypertension; White Coat Hypertensin; Hypertension Self-Monitoring; Telemedicine.